Jackson Sharon, Mercer Christopher, Singer Barbara Jennifer
a School of Surgery, FMDHS , The Centre for Musculoskeletal Studies, The University of Western Australia , Perth , Australia.
b Portsmouth Hospitals NHS Foundation Trust , Portsmouth , UK.
Disabil Rehabil. 2018 Feb;40(4):414-424. doi: 10.1080/09638288.2016.1258437. Epub 2016 Dec 28.
To explore factors influencing physical activity (PA) reported by people living in rural/semi-rural communities in the south of England post-stroke, and to understand relationships between personal, interpersonal and environmental barriers and self-reported levels of PA.
A survey was mailed to patients of NHS Trusts who were identified as potential participants. Self-reported PA levels, type, and frequency of reported barriers were tabulated. Spearman's rank correlation coefficient was used to explore associations between self-reported PA level and: age, gender, level of physical function, fear of falling, beliefs regarding PA, available supports, and socioeconomic status.
Seventy-six of 322 questionnaires distributed were returned (24%). Only 55.2% of respondents reported undertaking PA of sufficient intensity to meet current guidelines. Personal barriers included fear of falling, stroke-related disability, pain, and fatigue. Interpersonal and environmental barriers included lack of social support, transport, and inclement weather. Significant relationships existed between self-reported PA and fear of falling, functional mobility, and beliefs relating to PA.
Almost half of the survey cohort reported PA levels insufficient to meet current guidelines. Similar to barriers reported in previous studies in USA and other parts of the UK, numerous interlinking and overlapping personal, interpersonal, and environmental barriers to undertaking PA were identified. Implications for Rehabilitation This study found that although more than 60% of the survey population were able to ambulate >200 m, only 55.2% reported undertaking sufficient PA to meet current guidelines, putting them at increased risk of further stroke and other co-morbidities. Participants reported a number of interlinking and overlapping personal, interpersonal, and environmental barriers to undertaking PA, which may explain this discrepancy between mobility status and self reported activity levels. Rehabilitation professionals and primary care providers are well positioned to address the barriers identified in this survey, such as providing interventions to reduce fear of falling, pain, and fatigue, providing support and education about safely increasing physical activity and addressing unhelpful beliefs about PA. Behaviour change strategies, such as increasing self-efficacy, and partnering with the person with stroke to problem solve strategies to address the barriers identified by this, and related research, are likely to be more successful in increasing PA than providing information alone.
探讨影响英格兰南部农村/半农村社区中风后居民报告的身体活动（PA）的因素，并了解个人、人际和环境障碍与自我报告的PA水平之间的关系。
向被确定为潜在参与者的NHS信托机构的患者邮寄了一份调查问卷。将自我报告的PA水平、类型和报告的障碍频率制成表格。使用Spearman等级相关系数来探讨自我报告的PA水平与以下因素之间的关联：年龄、性别、身体功能水平、跌倒恐惧、对PA的信念、可用支持和社会经济地位。
在分发的322份问卷中，有76份被退回（24%）。只有55.2%的受访者报告进行了强度足够的PA以符合当前指南。个人障碍包括跌倒恐惧、中风相关残疾、疼痛和疲劳。人际和环境障碍包括缺乏社会支持、交通和恶劣天气。自我报告的PA与跌倒恐惧、功能移动性以及与PA相关的信念之间存在显著关系。
几乎一半的调查队列报告的PA水平不足以符合当前指南。与美国和英国其他地区先前研究中报告的障碍类似，确定了进行PA的众多相互关联和重叠的个人、人际和环境障碍。康复启示 本研究发现，尽管超过60%的调查人群能够行走超过2百米，但只有55.2%的人报告进行了足够的PA以符合当前指南，这使他们面临进一步中风和其他合并症的风险增加。参与者报告了进行PA的一些相互关联和重叠的个人、人际和环境障碍，这可能解释了移动状态与自我报告的活动水平之间的这种差异。康复专业人员和初级保健提供者有能力解决本调查中确定的障碍，例如提供干预措施以减少跌倒恐惧、疼痛和疲劳，提供关于安全增加身体活动的支持和教育，并解决对PA的无益信念。行为改变策略，如提高自我效能感，以及与中风患者合作解决本研究及相关研究所确定的障碍的策略，可能比单独提供信息在增加PA方面更成功。
